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ANALYSIS OF FREQUENCY OF PRIMARY HYPERALDOSTERONISM IN YOUNG HYPERTENSIVES IN PAKISTAN

Dr Hasnain Aslam, Dr Hassam Ahmed, Dr Navaira Hye

Introduction: Aldosterone, the major and most powerful mineralocorticoid hormone in humans, is synthesized from cholesterol in the adrenal cortex1 and governs the physiological control of renal electrolyte balance. Objectives of the study: The main objective of the study is to analyze the frequency of primary hyperaldosteronism in young hypertensives in Pakistan. Material and methods: This cross sectional study was conducted at BHU Dagger Qureshi, Bhakkar and DHQ Hospital, Khanewal during October 2018 to December 2018. There were 100 hypertensive patients who were selected for this study. We reviewed the clinical records of each patient, and we considered hypertensive those patients with a diastolic blood pressure (DBP) >90 mm Hg and a systolic blood pressure (SBP) >140 mm Hg on at least 2 occasions on different days who were not taking antihypertensive drugs at the time of diagnosis. All patients underwent a clinical examination and serum determinations of creatinine, calcium, urea, glucose, and hepatic profile. Results: The data were collected from 100 patients of both genders. The mean age of the patients is 54.1±11.2. The mean systolic BP was 156.1±15.8 and mean diastolic BP was 96.6±9.1. Twenty-one of 37 patients met all criteria for PA because they had high SA values (16.5 to 41.0 ng/dL), low levels of PRA (<0.5 ng · mL−1 · h−1), and a high SA-PRA ratio (>50) on at least 2 determinations. In the remaining 16 of 37 patients, the SA values were between 9 and 16 ng/dL. All patients confirmed as having PA had a baseline SA value >9 ng/dL; patients with SA levels lower than this always tested negative on the confirmatory FST, independent of the magnitude of the SA-PRA ratio. Conclusion: It is concluded that SA-PRA ratio is a useful screening method in the diagnosis of PA, because most patients are normokalemic. Frequency of primary hyperaldosteronism was found to be 10%, emphasizing on the fact that it is not very uncommon in young hypertensives.

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